Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD60903640 | WA |
NPI | 1518229152 |
---|---|
Provider Name | Kenneth Moy Chin |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98133-9451 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2012 |
Last Update Date | 17/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1518229152 | (05) | WA |